Cancer risks, beliefs, and health care access among the underprivileged.

6563 Background: One goal of the current French National Cancer Plan is to reduce health inequities in cancer control. In the present work, an underprivileged population was explored to analyze exposure to cancer risk factors and cancer screening attendance in order to highlight ways to improve cancer control. Methods: Within the nationwide observational study EDIFICE 3, conducted by phone interviews among a representative sample of 1603 subjects aged between 40 and 75 years old, we used the “EPICES” validated questionnaire to examine the association of underserved status with cancer risk factors, beliefs, and health care access. Results: Based on EPICES score, underserved subjects represent 33% of the sample. These subjects subjectively perceive a higher risk of cancer compared to non-underserved subjects (21% vs 14% respectively, p<0.01). They more often consider that the cancer always has an external cause (18% vs 12%, p<0.01), rely less on information from the general practitioner (48% vs 56%, p<0.01) and lay press (28% vs 37%, p<0.05). They trust the national health system less (average score from 1 to 10; 6.0 vs 6.3, p <0.05). They also have more cancer risk factors: BMI (26.0 vs 24.8, p<0.01), active smoking (38% vs 23%, p<0.01) and less practicing sport (42% vs 77%, p<0.01). They have more comorbidities: average (2.2 vs 1.8, p<0.01), at least one (76% vs 65%, p<0.01), anxiety (27% vs 12%, p<0.01), hypertension (24% vs 19%, p<0.05) and cardiovascular disease (13% vs 9%, p<0.05). Among persons with a cancer, underserved subjects have a higher rate of lung cancer (10% of cancers vs 1%, p<0.05). However, no difference in cancer screening attendance was observed between underserved and non-underserved subjects: colorectal cancer (60% vs 60%); breast cancer (94% vs 97%) and prostate cancer (46% vs 52%). Access to healthcare is not an issue (consultations with a general practitioner more frequent for underserved group: 5.4 vs 3.7 per year, p<0.01). Conclusions: To reduce inequities in cancer control, as screening attendance is not discriminating, the effort for upstream interventions should be focused on prevention. Cancer risk factors such as smoking, overweight and a sedentary life style are appropriate targets for communication campaigns.